Content-Analysis of Social Networks and

Mobile Phone Text Messages Among

HIV Patients in Tanzania

SoSon Jong, RN, PhD

Lisa Thompson, RN, PhD

University of California San Francisco

July 24 2016

1. Phenomenon

2. Review of the study

3. Report of content analysis

4. Discussion & Conclusion

5. Acknowledgement

Agenda

HIV/AIDS by numbers

http://www.unaids.org/en/resources/infographics

HIV prevalence in 2012 http://www.unaids.org/en/resources/infographics

Time for strategic HIV

response

http://www.unaids.org/en/resources/infographics

Social

Determinants

of health

“Circumstances where

people are born, grow up,

live and the system in

place to deal with illness”

(WHO, 2007)Definitions

http://blog.frontrunnerpro.com/wp-content/uploads/2016/02/social-media-management-1.jpg

● Social network

A structure where social

capital flows and

amplifies

● The currency of social

networks- Social capital

● Easily accessible

information and

networking capability

over mobile networks

Communication and educational platform

Mobile text message reminders to improve medication adherence and follow-up

appointment among PLWH

Have more potential to improve health service delivery

Use of mobile technologies in health care

“Features and resources-

social norm and trust, for

example, embedded in a

social structure which are

accessed/mobilized in

purposive action”

(Lin, 1999; Putnam, 2001)

Social Capital

Definition

Theoretical framework

Theory of Social Capital (Nan Lin, 1999)

Collective assets

(trust, norm,etc.)

Structural

positional

variations

Accessibility

(Network locations

and Resources

Mobilization (Use

of contact and

Contact resources

Returns

Instrumental

(Wealth, power,

reputation)

Returns

Expressive

(Physical, mental

health, life

satisfaction)

Inequality Capitalization Effects

Research aim

The study aimed to explore and understand HIV patients’ social networks and

support in relation to their use of mobile text messages (SMS). This study also

presents HIV patients’ perspectives on use of SMS for HIV care and management.

Overview of the Study

Design Cross-sectional design

Study period August - September 2015

Study locations 6 HIV clinics in Dar es Salaam, Tanzania

Study participants N=163

Measurements ● Questionnaire: Demographics, Social capital, Multidimensional

poverty index (MPI), Health related quality of life (SF12), social

networks

● Medical record review: HIV biomarkers and retention to care

● Individual interviews and Social network analysis

IRB Number: 14-15590

Figure 1. Deprivations in each poverty indicator

Poverty among the participants

● Incidence of poverty

(H)=23.5%

● Average intensity of

poverty (A)= 39.9%

● Multidimensional poverty

index (MPI)=HxA=0.09

● Tanzania

National level: 0.33

Urban average: 0.15

United nations development plan (UNDP)

Gender differences in social capital and QoL

Variables Total

(n=163)

Female

(n=124)

Male

(n=39)

t1 (df2) Significance

(p-value)

Social Capital

(mean, SD)

2.61

(0.45)

2.56 (0.07) 2.75 (0.04) -2.46

(69.37)

0.02

Quality of Life

(mean, SD)

42.91

(5.56)

42.3 (5.8) 44.7 (4.2) -2.87

(88.09)

0.005

1 T-test: unequal variance assumed2 Satterthwaite's degrees of freedom

>

Methods- Conventional content analysis

Questions developed by inductive category development

Systematic text analysis

Descriptive statistics and graphs

Assessing Social Networks:Looking back over the past 6 months, who are the people/ organizations with whom you discussed

matters important to you (list the relationships eg. Mother, friend 1, 2, partner, etc.)?

(Multiple choices allowed for

participants, N=163)

Assessing Social Networks:Looking back over the past 6 months, who are the people/ organizations with whom you discussed

matters important to you (list the relationships eg. Mother, friend 1, 2, partner, etc.)?

N=203 (multiple choices allowed for 163 participants)

Why uses mobile text messages (SMS)?

Ues of mobile text messages

What kind of message would you like to see?

Conclusions and Suggestions for road forward:

Mobile technologies and health

Mobile text messages are affordable and well-accepted

Mobile text messages are as effective as mobile phone calls

Bi-directional and personalized mobile text messages over automated, one way

reminders

Know recipients’ characteristics

Go beyond reminders: information, support, voucher, fund, network

http://www.medicine-on-time.com/img/cell.png

http://www.unaids.org/en/resources/infographics

Suggestions for road forward:

Social capital and Global health

People with high social capital,

More access to resources and opportunity

Leading to better health status, reputation, and wealth

Limited resources available in a given community,

Mobilizing flow of information, education, links to resources, and communication

to improve opportunity to better health and QoL

Benefiting more for people in resource-limited settings and vulnerable situations

Mobile technologies: effective platform at low cost

-------------------------------------------Acknowledgement

Dissertation committee: Lisa Thompson, Adam Carrico, Carmen Portillo

MUHAS mentors: David Urassa, Helen Siril

Dr. Bruce Cooper

Dr. Yvette Cuca

Research participants

Research assistants at MDH

Questions and Comments

This presentation was based on author’s research and synthesis of literatures.

List of references is available upon request.